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This is not an instant quote website; our prices are too low to list online. Please fill out the quote form to obtain a Umbrella insurance quote, and an insurance specialist will contact you shortly. Please understand this is not an application for insurance. An application will be sent to you if coverage is desired. |
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Umbrella Fact Finding Questions |
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Personal Information |
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Underwriting Information |
Are any aircraft owned, leased, chartered or furnished for regular use? |
Yes
No
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Do any drivers have mental or physical impairments? |
Yes
No
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Are any premises, vehicles, watercraft, aircraft used for business? |
Yes
No
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Are any premises, vehicles, watercraft, aircraft owned, hired, leased or regularly used not covered by the primary policies? |
Yes
No
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Do you engage in any type of farming operation? |
Yes
No
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Do you hold any non-remunerative positions? |
Yes
No
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Do you employ any residence employees? |
Yes
No
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Any non-owned property exceeding $1,000 in value in your care, custody or control? |
Yes
No
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Any non-owned business or professional activities included in the primary policies? |
Yes
No
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Does any primary policy have reduced limits of liability or eliminate coverage for specific exposures? |
Yes
No
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Was any coverage declined, cancelled or non-renewed within the past 5 years? |
Yes
No
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Any motorcycles, mopeds or all terrain vehicles owned? |
Yes
No
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Any other business activities conducted from your residence or premises? |
Yes
No
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If yes, Please explain. |
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Current Coverage Information |
Current Umbrella Insurance Company |
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Losses and Claims for the Last 5 years? |
Yes
No
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If yes, what is the date, amount paid and description of each loss or claim. |
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Liability Limit: |
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Additional Information, Comments, Recommendations: |
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